ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures

BMC Psychiatry

Merete Øie³  Kjell Tore Hovik¹  Per Normann Andersen¹  Martin H Teicher²  Erik Winther Skogli¹ 

[1] Innlandet Hospital Trust Lillehammer, Division Mental Health Care, Oslo, Norway;Harvard Medical School, Boston, USA;Department of Psychology, University of Oslo, Innlandet Hospital Trust Lillehammer, Division Mental Health Care, Oslo, Norway

关键词: BRIEF;    Executive functions;    Comorbidity;    Gender;    ADHD;   

Others  :  1123898
DOI  :  10.1186/1471-244X-13-298

 received in 2012-11-04, accepted in 2013-11-05,  发布年份 2013

【 摘 要 】

Background

ADHD is diagnosed and treated more often in males than in females. Research on gender differences suggests that girls may be consistently underidentified and underdiagnosed because of differences in the expression of the disorder among boys and girls. One aim of the present study was to assess in a clinical sample of medication naïve boys and girls with ADHD, whether there were significant gender x diagnosis interactions in co-existing symptom severity and executive function (EF) impairment. The second aim was to delineate specific symptom ratings and measures of EF that were most important in distinguishing ADHD from healthy controls (HC) of the same gender.

Methods

Thirty-seven females with ADHD, 43 males with ADHD, 18 HC females and 32 HC males between 8 and 17 years were included. Co-existing symptoms were assessed with self-report scales and parent ratings. EF was assessed with parent ratings of executive skills in everyday situations (BRIEF), and neuropsychological tests. The three measurement domains (co-existing symptoms, BRIEF, neuropsychological EF tests) were investigated using analysis of variance (ANOVA) and random forest classification.

Results

ANOVAs revealed only one significant diagnosis x gender interaction, with higher rates of self-reported anxiety symptoms in females with ADHD. Random forest classification indicated that co-existing symptom ratings was substantially better in distinguishing subjects with ADHD from HC in females (93% accuracy) than in males (86% accuracy). The most important distinguishing variable was self-reported anxiety in females, and parent ratings of rule breaking in males. Parent ratings of EF skills were better in distinguishing subjects with ADHD from HC in males (96% accuracy) than in females (92% accuracy). Neuropsychological EF tests had only a modest ability to categorize subjects as ADHD or HC in males (73% accuracy) and females (79% accuracy).

Conclusions

Our findings emphasize the combination of self-report and parent rating scales for the identification of different comorbid symptom expression in boys and girls already diagnosed with ADHD. Self-report scales may increase awareness of internalizing problems particularly salient in females with ADHD.

【 授权许可】

   
2013 Skogli et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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